Medicine and Health Sciences Commons^™

Relationship Between Familism And Sexual Attitudes Among College Students, Joseph Rampersad

Walden Dissertations and Doctoral Studies

In the United States, college students face an increased risk of sexually transmitted diseases, sexual assault, and unwanted pregnancy due to experimental sexual behavior compared to individuals who do not attend college. Based on the theoretical framework of familism, the purpose of this study was to examine the relationship between sexual attitudes and familism among college students. Data were collected from nontraditional adult students who attend an online institution of higher education. The Familism Scale and the Brief Sexual Attitudes Scale were used to measure the variables of familism and attitudes about sex. Findings from multiple linear regression analyses indicated …

Influence Of Dual Process Decision-Making Theory In Patients Diagnosed With Cancer, Bonnie D. Quinonez

Walden Dissertations and Doctoral Studies

Each year millions of people face the medical decision-making cycle that comes with a diagnosis of cancer. For patients and their families, this can be a rollercoaster of confusion and fear. Researchers have indicated that the complexity of the decision-making process is underrepresented in the current approach of informed decision-making. The purpose of this study was to add to scientifically-validated research expanding the identification of factors that influence decision-making for individuals diagnosed with cancer. Fuzzy trace theory (FTT) is the dual process memory theory used as the framework for this study. Qualitative data were collected using semistructured interviews with 10 …

A Clinical Practice Guideline To Reduce Behavioral Outbursts In Veterans With Posttraumatic Stress Disorder, Mary Adejumoke Badru

Walden Dissertations and Doctoral Studies

In a Department of Veterans Affairs hospital on the East Coast of the United States, behavioral outbursts result in 2 out of 10 veterans dismissed from a posttraumatic stress disorder (PTSD) unit prior to completing the 6-week program. The purpose of this evidence-based quality improvement project was to create a clinical practice guideline (CPG) based on social cognitive theory (SCT) to provide new strategies for managing veterans with PTSD and to improve the confidence of the nurses in managing outbursts. The Star Model guided the project development with the Delphi method to achieve participant consensus, the AGREE II to assess …

Staffing Model To Improve Patient Outcomes In An Acute Inpatient Rehabilitation Facility, Ann Marie Evans

Walden Dissertations and Doctoral Studies

The goal of the acute inpatient rehabilitation facility (IRF) is to rehabilitate patients and discharge them back into the community at their optimal level of functioning. The IRF patient is more acutely ill today than in the past, and due to a change in condition may be discharged back into the acute care hospital before achieving maximal level of function. An IRF was identified as discharging 14% of patients back into acute care, which indicated the IRF was not meeting its treatment goals. A chart review revealed a possible link between the nurse's role in patient care and the patient's …

Effect Of Self-Determination, Motivation, And Dispositional Optimism With Physical Therapy In Geriatric Patients, Leslie Yaneth Urias-Bodnar

Walden Dissertations and Doctoral Studies

Older people are frequently faced with physical conditions that require treatment. A better understanding of the components of engagement relating to the outcomes of treatment was the focus of the study. The purpose of this quantitative study was to examine whether there was an association between the independent variables of optimism, pessimism, motivation, and self-determination and their impact on the dependent variable of achieving physical activity goals in 86 geriatric patients, ages 65 to 80 receiving physical therapy services. The theoretical framework of self-determination, motivation, optimism, and pessimism was assessed by using two self-report questionnaires, The Self-Determination Scale and The …

Nurse Practitioners' Guide On Consumption Of Hundred Percent Fruit Juice By Children, Monisola Adeyemo

Walden Dissertations and Doctoral Studies

Childhood obesity has reached an epidemic level in the United States, growing exponentially and posing a great risk to the current and future health of the American people. The trend of increasing incidence of overweight and obesity in children has been occurring for decades; there is a need for multimodal preventative solutions to control the rate of growth. Sufficient evidence has shown a correlation between the feeding of 100% fruit juice to infants as dietary supplements and childhood obesity. Therefore, the purpose of this project was development of a guideline for 100% fruit juice feeding in children that is adaptable …

Diabetes Self-Management Problems Of Older, Low-Income African American Women, Pearlean Day Day

Walden Dissertations and Doctoral Studies

Type 2 diabetes disproportionately affects low-income African American women, age 50 years and older: 30% to 40% of this population has this chronic disease. Two significant factors affecting poor diabetes practice adherence are food insecurity and depression; another is obesity. The purpose of this quantitative correlational study was to determine if either food insecurity or depression significantly affect Type 2 diabetes self-management practices; and/or if food insecurity significantly influences practice adherence indirectly, through the mediator of depression, while controlling for obesity. The research questions were aligned with the theoretical pathways posited in Matthews's reserve capacity model (RCM) and used the …

Preoperative Chlorhexidine Skin Preparation For Patients Undergoing Vascular Surgery, Janine Lee-Anne Duquette

Walden Dissertations and Doctoral Studies

In response to improving quality patient care, combined with the growing rates of surgical site infections (SSIs) in vascular patients, the need to explore current practice trends with current evidence has been identified. SSIs affect quality patient care and compromise patient safety. Empirical evidence has recommended the use of a chlorhexidine wash preoperatively to reduce SSIs. Despite this recommended practice, vascular patients were not receiving it in their routine plan of care within a hospital organization in southern Ontario. Guided by Lewin's theory of planned change, this project explored how the planning of a chlorhexidine preoperative surgical skin preparation protocol …

Pathopoiesis Mechanism Of Smoking And Shared Genes In Pancreatic Cancer, Ulysses Labilles

Walden Dissertations and Doctoral Studies

Pancreatic cancer (PC) remains a significant, unresolved issue because of its complex genetic blueprint and lack of reliable detection markers. The purpose of this study was to examine the possible correlation between tobacco use, gender, and age in the etiopathogenesis of PC and other cancer types with a shared-gene association (CTSG-A). The unified paradigm of cancer causation was used to understand the pathopoiesis mechanism of smoking and shared genes in PC. A cross-sectional study was performed using secondary data from the cancer survivorship module of the 2014 Behavioral Risk Factor Surveillance System survey. Results of ordinal logistic regression analyses indicated …

Historical Trauma's Impact On Dating Violence And Pregnancy Among Urban Native Americans, Shannon Barnes

Walden Dissertations and Doctoral Studies

Native Americans have high rates of teen births and intimate partner violence, though little is known about how historical trauma impacts these experiences. The research that has been conducted on teen pregnancy and violence has been among reservation-based Native Americans; little research has been conducted on the experiences of urban Native Americans. The research question for this study examined the potential impact of historical trauma on the lives of parenting urban Native Americans. This phenomenological study gathered the narrative lived experiences of participants via semistructured interviews. Purposeful random sampling was used to recruit 7 parenting urban Native American teens aged …

The Barriers And Quality Of Care Issues For Individuals Diagnosed With 22q11.2 Deletion Syndrome, Barbara Bavette Miller

Walden Dissertations and Doctoral Studies

Individuals diagnosed with 22q11.2 deletion syndrome (22q) have many barriers and quality of life issues associated with the condition. Without an obvious anomaly, affected individuals may live years without a proper diagnosis. The purpose of this qualitative case study research was to explore perceptions of caregivers of individuals with 22q. Uncertainty in illness theory was used as it describes the inability to find answers with unpredictable medical issues. The central research question focused on at how challenges associated with a 22q diagnosis are addressed. Interviews were conducted with 10 caregivers. Guided by the uncertainty in illness theory, data analysis was …

Predictors Of Human Papillomavirus Vaccination In Georgia, Ashley Nash

Walden Dissertations and Doctoral Studies

Although the human papillomavirus (HPV) vaccine has been approved by the Federal Drug Administration (FDA) and is available for males and females, completion of the 3-shot series in Georgia remains relatively low. The purpose of this study was to examine the predictors of HPV vaccination initiation and completion for male and female adolescents, ages 13 to 17 years old, in Georgia between 2013 and 2015. The theoretical foundation of the study was the structural model of health behavior which is an ecological model. Logistic regression was performed to determine if there was any relationship between the independent variables of parental …

Effectiveness Of A 10-Week Weight Reduction Program In A Retail Clinic, Love Chibuihe Nzeako

Walden Dissertations and Doctoral Studies

Obesity is a serious health problem that leads to several chronic diseases and premature deaths. TheIn this project,was used to evaluate the effectiveness of the the Weigh Forward (WF) program, a 10-week weight-loss program administered in retail clinics, was evaluated, and it is provided in retails stores. The project analysis was completed on a limited data set on The population consisted of 15 obese participantsmembers of the program, 18 years and above, at 13 dispersed clinics in Maryland and Virginia.in the WF program from 13 dispersed clinics in Maryland and VirgiObesity is a body mass index (BMI) > 30 kg/m2. Participants …

How Parenting Behaviors Influence Weight And Health Status Of African American Adolescents, Natasha T. Hourel

Walden Dissertations and Doctoral Studies

There has been an upward trend in obesity among African American (AA) adolescents over the last 2 decades. While parenting characteristics (e.g., styles and practices) are linked to adolescent eating habits and weight status, related research has focused on European American children from 2-parent middle-class households or economically disadvantaged AA children from single mother households. The purpose of this quantitative secondary data analysis was to investigate the relationship between parenting characteristics on the weight status of adolescents aged 12 to 17 years (n = 325) among a broader population of AA mothers and fathers residing both inside and outside of …

Nursing Leadership Influence On Evidence-Based Practice Culture And Integration, Natalie Kay Lenhart

Walden Dissertations and Doctoral Studies

Translating research to practice takes 10-20 years or more and evidence-based practice (EBP) integration remains at 10%-20%, despite recommendations requiring EBP-guided decisions. EBP integration has been associated with up to 30% decreases in healthcare system spending, improved quality outcomes, and increased staff satisfaction. Nurse leaders are accountable for EBP enculturation, yet rate quality and safety as the highest priority and EBP as the lowest. This knowledge gap perpetuates low EBP integration rates and hinders EBP enculturation. Asking whether EBP facilitative interventions for nurse leaders increase scores on organizational culture and readiness, beliefs, and EBP use scales addressed the knowledge gap …

Improving The Quality Of Nursing Documentation In Home Health Care Setting, Chidiadi Obioma

Walden Dissertations and Doctoral Studies

Poor nursing documentation of patient care was identified in daily nurse visit notes in a health care setting. This problem affects effective communication of patient status with other clinicians, thereby jeopardizing clinical decision-making. The purpose of this evidence-based project was to determine the impact of a retraining program on the quality of documentation of patient care in nurses' notes in a home health agency in central Texas. A retrospective audit of quality of nursing documentation using the Nurse and Midwifery Content Audit Tool (NMCAT) was done. A pre- and posttest design was used. A convenience sample of de-identified nurses' notes …

Experiences Of Middle-Aged, African American Women With Excessive Weight, Tina Ann Mcclaire

Walden Dissertations and Doctoral Studies

Obesity and overweight issues are nationally recognized crises for African American women. A noteworthy gap remains in the literature regarding this population's experiences with excessive weight, specifically, the role of culture and social support networks on their experience with being overweight. Without an understanding of the experience and meaning of being overweight for African American women, physicians and clinicians will not be able to fully support African American women in their weight loss journeys. Using the social learning theory as a framework, the purpose of this phenomenological research study was to explore experiences of obese or overweight middle-aged African American …

Managing Multiple Goals In Opioid Prescription Communication: Perspectives From Trauma Physicians, Elizabeth T. Adams

Theses and Dissertations--Communication

Prescription opioids and heroin account for more than half of all drug overdose fatalities, claiming an estimated 91 American lives every day (Rudd, Seth, David, & Scholl, 2016). The ongoing opioid epidemic represents a tremendous burden to the national economy and healthcare system (Rudd, Aleshire, Zibbell, & Gladden, 2016). In 2016, the Centers for Disease Control and Prevention and the White House Office of National Drug Control Policy proposed action to train prescribers on the proper dispensing of opioids, which are indispensable pharmacologic resources for treating acute pain resulting from trauma or surgery. This study examines the prescribing practices of …

Different Ret Gene Mutation-Induced Multiple Endocrine Neoplasia Type 2a In 3 Chinese Families, Qiuli Liu, Dali Tong, Wenqiang Yuan, Gaolei Liu, Gang Yuan, Weihua Lan, Dianzheng Zhang, Jun Zhang, Zaoming Huang, Yao Zhang, Jun Jiang

PCOM Scholarly Works

BACKGROUD: Multiple endocrine neoplasia type 2A (MEN2A) is a condition with inherited autosomal dominant mutations in RET (rearranged during transfection) gene that predisposes the carrier to extremely high risk of medullary thyroid cancer (MTC) and other MEN2A-associated tumors such as parathyroid cancer and/or pheochromocytoma. Little is reported about MEN2A syndrome in the Chinese population.

METHODS: All members of the 3 families along with specific probands of MEN2A were analyzed for their clinical, laboratory, and genetic characteristics. Exome sequencing was performed on the 3 probands, and specific mutation in RET was further screened on each of the family members.

RESULTS: Different …

Time Course Expression Analysis Of 1[2-Cyano-3,12-Dioxooleana-1,9(11)-Dien-28-Oyl]Imidazole Induction Of Cytoprotection In Human Endothelial Cells., James A Bynum, Xinyu Wang, Salomon A Stavchansky, Phillip D Bowman

PCOM Scholarly Works

1[2-cyano-3,12-dioxooleana-1,9(11)-dien-28-oyl]imidazole (CDDO-Im), a synthetic derivative of oleanolic acid that exhibits antioxidant and anti-inflammatory activity in several animal and in vitro models, has been shown to be beneficial if given after injury. Although induction of heme oxygenase 1 appears to be a major effector of cytoprotection, the mechanism by which the overall effect is mediated is largely unknown. This study evaluated temporal gene expression profiles to better characterize the early transcriptional events and their relationship to the dynamics of the cytoprotective response in human umbilical vein endothelial cells (HUVEC) to CDDO-Im. Time-course gene expression profiling was performed on HUVEC treated with …

Tgfβƒ1 Promotes Gemcitabine Resistance Through Regulating The Lncrna-Let/Nf90/Mir-145 Signaling Axis In Bladder Cancer, Junlong Zhuang, Lan Shen, Lin Yang, Xiaojing Huang, Qun Lu, Yangyan Cui, Xi Zheng, Xiaozhi Zhao, Dianzheng Zhang, Ruimin Huang, Hongqian Guo, Jun Yan

PCOM Scholarly Works

High tumor recurrence is frequently observed in patients with urinary bladder cancers (UBCs), with the need for biomarkers of prognosis and drug response. Chemoresistance and subsequent recurrence of cancers are driven by a subpopulation of tumor initiating cells, namely cancer stem-like cells (CSCs). However, the underlying molecular mechanism in chemotherapy-induced CSCs enrichment remains largely unclear. In this study, we found that during gemcitabine treatment lncRNA-Low Expression in Tumor (lncRNA-LET) was downregulated in chemoresistant UBC, accompanied with the enrichment of CSC population. Knockdown of lncRNA-LET increased UBC cell stemness, whereas forced expression of lncRNA-LET delayed gemcitabine-induced tumor recurrence. Furthermore, lncRNA-LET was …

Genetic Identification And Molecular Modeling Characterization Reveal A Novel Prom1 Mutation In Stargardt4-Like Macular Dystrophy, Saber Imani, Jingliang Cheng, Marzieh D. Shasaltaneh, Chunli Wei, Lisha Yang, Shangyi Fu, Hui Zou, Md. Asaduzzaman Khan, Xianqin Zhang, Hanchun Chen, Dianzheng Zhang, Chengxia Duan, Hongbin Lv, Yumei Li, Rui Chen, Junjiang Fu

PCOM Scholarly Works

Stargardt disease-4 (STGD4) is an autosomal dominant complex, genetically heterogeneous macular degeneration/dystrophy (MD) disorder. In this paper, we used targeted next generation sequencing and multiple molecular dynamics analyses to identify and characterize a disease-causing genetic variant in four generations of a Chinese family with STGD4-like MD. We found a novel heterozygous missense mutation, c.734T>C (p.L245P) in the PROM1 gene. Structurally, this mutation most likely impairs PROM1 protein stability, flexibility, and amino acid interaction network after changing the amino acid residue Leucine into Proline in the basic helix-loop-helix leucine zipper domain. Molecular dynamic simulation and principal component analysis provide compelling …

Ertapenem-Induced Encephalopathy In A Patient With Normal Renal Function, S. Scott Sutton, Mark Jumper, Michael D. Wyatt

Faculty Publications

Drug-induced neurotoxicity is a rare adverse reaction associated with ertapenem. Encephalopathy is a type of neurotoxicity that is defined as a diffuse disease of the brain that alters brain function or structure. We report a patient with normal renal function who developed ertapenem-induced encephalopathy manifesting as altered mental status, hallucinations, and dystonic symptoms. The patient’s symptoms improved dramatically following ertapenem discontinuation, consistent with case reports describing ertapenem neurotoxicity in renal dysfunction. Since clinical evidence strongly suggested ertapenem causality, we utilized the Naranjo Scale to estimate the probability of an adverse drug reaction to ertapenem. Our patient received a Naranjo Scale …

Planet Health: A School-Based Health Promotion Program, Jane Katherine Landon

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The Kentucky River District Health Department (KRDHD) proposes implementation of Planet Health, a school-based intervention aimed at increasing healthful nutrition and fitness behaviors in middle- and high-school aged students. Planet Health’s core messaging (increasing fruit and vegetable intake, increasing physical activity, decreasing screen time, decreasing sugar-sweetened beverage and trans-fat intake) contributes to our long-term goal of decreasing childhood obesity in our service area. Planet Health will be offered to 3 counties in our service area (Lee, Letcher and Wolfe) with planned expansion to all counties in the KRDHD service area within 5 years of the original pilot. This project will …

Spatio-Temporal Analysis Of Childhood Retinoblastoma And Cns Tumors In Kentucky, From 1995 Through 2014, Jennifer A. Khoury

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives

Childhood cancer poses a significant public health burden, both globally and in the United States (US). The most common childhood cancers affect the brain and central nervous system (CNS). Age-adjusted childhood brain tumor (CBT) incidence rates in Kentucky are larger than in the rest of the US; these rates are also higher in Appalachian Kentucky than in the rest of the state. This study determined if high-rate clusters of either CNS tumor or retinoblastoma existed in Kentucky.

Methods

Data for this study were retrieved from the Kentucky Cancer Registry for the years 1995 through 2014. Cases were individuals between …

All 4 Hardin County Freshman!, Cortney Lynn Gandy

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Within this application for funding the Lincoln Trail Health Department proposes an evidenced based intervention for implementation into two high schools in the Hardin County with the long term goals of decreasing the rate of sexually transmitted infections in the county. The LTHD based in Elizabethtown, Kentucky services six counties in central Kentucky. The community health needs assessment and community health improvement plans for the county highlighted the problem of sexually transmitted infections in the community. The Centers for Disease Control also produces data about the higher rate of STIs in Hardin county in respect to Kentucky and the US …

Your Guide To Immunotherapy, Lehigh Valley Health Network, Accc Association Of Community Cancer Centers

Lehigh Valley Topper Cancer Institute

No abstract provided.

The Real Culprit Behind Diabetic Nephropathy: Impaired Renal Autoregulation?, Ruisheng Liu

Molecular Pharmacology & Physiology Faculty Publications

No abstract provided.

Triple Triumph: Three Women In Medicine

Syracuse Unbound

Triple triumph: Three women in medicine is the story of three physicians.

Three physicians, all women, each perceived serious unmet needs in their fields, and envisioned imaginative approaches to meeting those needs. Each encountered resistance, discouragement, and obstruction from the traditional, male-dominated departments in which they worked. These powerful pioneers, undeterred, created programs that earned the highest levels of national distinction and acclaim. Their work and their names are now legendary—in geriatric medicine, in the treatment of breast cancer, and in diabetes research and treatment. Their stories differ, but the commonalities help us understand why constructive change is often so …

A Systems Approach To Improving Delivery And Update Of Facility-Based Hiv Testing And Linkage To Care In South Africa, Project Soar

HIV and AIDS

Project SOAR is examining the current delivery of HIV testing (HTS) and linkages to care (LTC) services—including barriers, facilitators, and infrastructure—in Ekurhuleni District, South Africa which has the second-highest district-level HIV prevalence in the country. Based on these formative findings, the project will develop and test tailored approaches to increase patients’ uptake of HTS and subsequent LTC, if positive. The project expects to find evidence of HTS coverage outside of antenatal care; document key systems-level barriers to HTS and LTC; assess potentially generalizable clinic-level strategies to increase HTS delivery and assess LTC needs; and identify the added value for implementation …